---
title: "What Is the IMLC? Interstate Medical Licensure Compact"
description: "The IMLC gives qualified physicians a faster path to licenses in member states. How the compact works, what it does not cover, and how Cuvo Health uses it."
canonical: "https://cuvo.co/glossary/interstate-medical-licensure-compact"
last-updated: "Oct 26, 2026"
---
**Definition:** The Interstate Medical Licensure Compact (IMLC) is an agreement among member states that gives qualified physicians a voluntary, expedited path to licensure in several states, with each member state still issuing its own full license.

# What is the Interstate Medical Licensure Compact (IMLC)?

The Interstate Medical Licensure Compact is the fastest lawful way for a physician to add state licenses, but it is not a national license and it does not reach every state. Telehealth is regulated where the patient is, so a brand selling nationally still needs a licensed provider for every state its patients are in. Cuvo Health holds that licensure for its network before a brand launches.

Published Oct 26, 2026. Facts reviewed Oct 26, 2026.

The Interstate Medical Licensure Compact (IMLC) is an agreement among member states that gives qualified physicians a voluntary, expedited path to licensure in several states. A physician qualifies through a state of principal license, receives a Letter of Qualification, and then requests licenses from other member states, each of which issues its own full license on its own renewal cycle. The Interstate Medical Licensure Compact Commission runs the process; the state boards issue the licenses. Under the compact, the location of medical practice is the state where the patient is located. Cuvo Health files compact applications for eligible physicians, obtains full licenses board by board where the compact does not reach, and holds licensure across all 50 states, DC, Puerto Rico, Guam and the US territories before a brand launches.

**At a glance**
- What it is: A voluntary, expedited licensing pathway for physicians across member states
- Who it covers: Physicians who meet the compact's eligibility rules; not nurse practitioners or physician assistants
- What it produces: A separate full license from each member state the physician chooses
- The gateway: A Letter of Qualification from the state of principal license, valid for 365 days
- What it is not: A national license; states outside the compact still require their own license
- On Cuvo: Compact applications for eligible physicians, full licenses elsewhere, all 50 states covered before launch

**How a license moves through the IMLC (imlcc.com, checked October 26, 2026)**

| Step | What happens | Who handles it |
| --- | --- | --- |
| **Eligibility** | Full, unrestricted license in the state of principal license; accredited training; each USMLE or COMLEX-USA component passed in no more than three attempts; specialty certification; no disciplinary, criminal or controlled-substance history | State of principal license |
| **Letter of Qualification** | Issued once eligibility is verified, including a fingerprint background check; valid for 365 days | State of principal license |
| **Licenses** | Each chosen member state issues its own license on receipt of the letter and charges its own fee | Each member state board |
| **Renewal** | Each license renews on its state's schedule, through the compact website | The physician, with each state |
| **Practice rules** | All laws and regulations of the patient's state apply to the visit | The state where the patient is located |

## 01. Why does the IMLC matter for a telehealth brand?

A telehealth visit is regulated in the state where the patient is located, so a brand that sells nationally needs a provider licensed in every state its patients are in. For physicians in member states, the compact turns many separate applications into one qualification and a set of license requests, which is the main reason national physician coverage is achievable at all. It does not cover every state, and it does nothing for nurse practitioners or physician assistants. The compact state list, with each state's fee, is kept on Cuvo's IMLC states page.

## 02. How is the IMLC different from a national license?

There is no national medical license, and the compact does not create one. What it produces is a set of ordinary state licenses. Once a license is issued, the IMLC Commission notes, the physician comes under the jurisdiction of the licensing state's statutes, rules and board regulations, and member boards share complaint and investigative information with each other. Each license carries its own fee and renewal, so a physician licensed in many states through the compact still maintains many licenses.

## 03. How is the IMLC different from the Nurse Licensure Compact?

The Nurse Licensure Compact issues one multistate license from a nurse's home state that is recognized in the other compact states. The IMLC issues separate licenses from each state. The Nurse Licensure Compact also stops short of the clinicians who prescribe on most telehealth programs: it covers registered nurses and licensed practical or vocational nurses only, and an advanced practice registered nurse must hold an individual license in each state of practice.

## 04. Does a telehealth brand need to use the IMLC?

A brand does not apply to the compact; physicians do. A brand that builds its own network inherits the work for every physician: eligibility checks, fingerprints, a Letter of Qualification that lapses after a year, a fee per state, renewals on each state's schedule, and full licenses in every state outside the compact. On Cuvo, that licensing is already in place for the network before a brand's first patient, and the brand never files a license or tracks a renewal.

## Frequently asked questions

**Q: What is the Interstate Medical Licensure Compact?**

A: It is an agreement among member states that gives qualified physicians a voluntary, expedited path to licenses in several states, with each state still issuing its own full license. On Cuvo, compact applications are filed for eligible physicians and full licenses are held everywhere else, so the network covers all 50 states before launch.

**Q: Is an IMLC license a national medical license?**

A: No. The compact produces separate state licenses, each under that state's board, fees and renewal cycle. Cuvo Health holds those licenses for its network across all 50 states, DC and the US territories, so a brand never manages them.

**Q: Does the IMLC cover nurse practitioners and physician assistants?**

A: No. The compact is a physician licensing pathway, and nurse practitioners and physician assistants are licensed under their own state rules. Cuvo Health's network of physicians, nurse practitioners and physician assistants is licensed across all 50 states, and each visit routes only to a provider licensed where the patient is located.

**Q: IMLC vs Nurse Licensure Compact: what is the difference?**

A: The IMLC helps physicians obtain separate licenses from member states, while the Nurse Licensure Compact gives registered and practical nurses one multistate license from their home state. Neither covers nurse practitioner practice. On Cuvo, licensure for every provider type is held before launch, whichever route each state allows.

**Q: Does a telehealth brand need the IMLC?**

A: Only if it builds its own physician network, because physicians, not brands, apply through the compact. Cuvo Health has already licensed its network through the compact where it applies and board by board elsewhere, at $25 per completed consult with no revenue share.

**Related pages**

- [IMLC states in 2026](/compliance/imlc-states): Which states issue compact licenses, with MD fees
- [Nurse Licensure Compact (NLC)](/glossary/nurse-licensure-compact): The multistate license for RNs and LPN/VNs
- [Originating site and distant site](/glossary/telehealth-originating-site): Why licensure follows the patient
- [Telehealth licensing and credentialing across all 50 states](/blog/fifty-state-provider-network): Licensure, the compact and credentialing in depth
- [The 50-state provider network](/provider-network): 300+ board-certified MDs, NPs and PAs
- [Telehealth glossary](/glossary): Every term a telehealth founder meets

Canonical page: https://cuvo.co/glossary/interstate-medical-licensure-compact